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Permit (103) CITY OF TIGARD SITE WORK PERMIT 114 COMMUNITY DEVELOPMENT Permit#: SIT2019-00007 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 04/23/2019 TIGARD 9 Parcel: 2S107AA26300 Jurisdiction: Tigard Site address: 14450 SW RIVER TERRACE BLVD Project: Polygon at Roshak Ridge Swim Center Subdivision: ROSHAK RIDGE Lot: U Project Description: Site work for Roshak Ridge Swim Center. Contractor: NORTHWEST EARTHMOVERS INC Owner: POLYGON WLH LLC PO BOX 1609 703 BROADWAY ST STE 510 SHERWOOD,OR 97140 VANCOUVER,WA 98660 PHONE: 503-625-3100 PHONE: 360-695-7700 FAX: 503-625-3108 FEES Description Date Amount Specifics: Permit Fee-Site Work 04/23/2019 $854.32 Plan Review 03/19/2019 $555.31 Type of Use: COM 12%State Surcharge-Building 04/23/2019 $102.52 Class of Work: ALT Info Process/Archiving-Lg$2.00(over 04/23/2019 $22.00 11x17) Project Valuation: $109,784.00 Info Process/Archiving-Sm$0.50(up to 04/23/2019 $12.50 11x17) Erosion Control w/Development 04/23/2019 $236.40 Site Specifics: Excavation Volume: 162 cu.yd. Fill Volume: 1201 cu.yd. Impervious Surface: 4000 sq.ft. Engineered Fill: Yes Soil Report Required: No Paving: Yes Grading: Yes Landscaping: Yes Site Prep: No Storn Drains: Retaining Wall: Fire Underground: No Accessible Parking: Fence: No Total $1,783.05 Required Items and Reports(Conditions) This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules or direct questions t. a NC • ailing 03.232.1987 or 1.800.332.2344. / Issued By: / 7'/ Permittee Signature: v 7i1-t4/2-/C.9-7-7e) 'v Call 503.639.4175 by 7:00 a.m.for the next available inspection date. This permit card shall be kept in a conspicuous place on the job site until completion of the project. Approved plans are required on the job site at the time of each inspection. ` Building Permit Application Site Work FOR OFFICE USE ONLI' City of Tigard r�, Date/B : g Received /� /����� III 4 13125 SW Hall Blvd.,Tigard,OR 97223 MARI ; Plan Revi. G /J I�, Phone: 503.718.2439 Fax: 503.598.1960 Date/B : 1 ' Other Permit: 1-I G n RI, Inspection Line: 503.639.4175 Date Ready/By: 6011_Juris: H See Page 2 for Internet: www.tigard-or.gov 4; ;tib Notified/Method: 1/ / g Supplemental Information ---11".1:11-- '97✓G f k :T TYPE'Ott"Oil" , ' "RtQt)littfi 1 A CrAt"1-AND -11!AMHiYIVWELIANG ®New construction El Demolition Permit fees*are based on the value of the work performed. Indicate the value(rounded to the nearest dollar)of all ❑Addition/alteration/replacement ❑Other: equipment,materials,labor,overhead,and the profit for the CATEGORY © CONSTtUCTION , work indicated on this application. El1-and 2-family dwelling ®Commercial/industrial Valuation: $ IDAccessory building 0 Multi-family Number of bedrooms: 0 Master builder 0 Other: Number of bathrooms: JOB SITE INFORMATION AND"CATION; Total number of floors: Job site address:14450 SW River Terrace Blvd New dwelling area: square feet City/State/ZIP:Tigard,OR 97224 Garage/carport area: square feet Suite/bldg./apt.no.:N/A Project name:Roshak Ridge Covered porch area: square feet Cross street/directions to job site:North of Bull Mountain Road Deck area: square feet Other structure area: square feet REQUIRED DATA:COMMERCIAL-ESE t�CK.LIST Subdivision:Polygon at Roshak Ridge Lot no.:U Permit fees*are based on the value of the work performed. Tax map/parcel no.:2S107AA26300 Indicate the value(rounded to the nearest dollar)of all equipment,materials,labor,overhead,and the profit for the DE CR.WTION OF WORK work indicated on this application. Construction of Roshak Ridge Swim Center Valuation: $ g J $IA Existing building area: square feet New building area: square feet 0 PROPERTY OWNER 0 TENANT Number of stories: Name:Polygon WLH LLC Type of construction: Address:703 Broadway Street Suite 510 Occupancy groups: City/State/ZIP:Vancouver,WA 98660 Existing: Phone:(360)695-7700 Fax:(360)693-4442 New: 0 APPLICANT 0 CONTACT PERSON = NOTICE Business name:same as owner All contractors and subcontractors are required to be Contact name: licensed with the Oregon Construction Contractors Board under ORS 701 and may be required to be licensed in the Address: jurisdiction in which work is being performed.If the City/State/ZIP: applicant is exempt from licensing,the following reasons apply: Phone:( ) Fax::( ) E-mail: ;:CONTRACT Business name:Northwest Earthmovers,Inc. BU'ILDINGPE YMTT PEES*' Address:13600 SW Galbreath Dr.PO Box 1609 Structural plan review fee(or deposit): City/State/ZIP:Sherwood,OR 97140 Phone:(503)858-9231 Fax:( ) FLS plan review fee(if applicable): CCB lic.:62761 Total fees due upon application: ii,, Amount received: Authorized signature: �`, . This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. Print name: ` -A C �A .-`,* �, Date: 5 I tr 3 k CI * Fee methodology set by Tri-County Building Industry Service Board. I:\Building\Permits\SIT-PermitApp.doc 08/02/2016 440-4613T(11/02/COM/WEB) City of Tigard: Site Work Permit Checklist Page 2-Supplemental Information Commercial,Multi-Family and One-and Two-Family Dwellings: No permit is required if fill is less than 50 yards(5 dump truck loads), or less than 3 feet deep and will not be supporting a structure. If a building will be constructed on the fill, it must be engineered fill. If fill is in a flood plain,drainage way, or wetland,the applicant must apply for a sensitive lands review (SLR). Please complete all items below,unless otherwise noted. Excavation Volume: 162 cu.yds. Grading Volume: (Soils report required for>5,000 cu.yds.) 1363 cu.yds. Fill Volume: (Fill exceeding 12"in depth shall be compacted to 90%of maximum density) 1201 cu.yds. Retaining structure? (Check one) ❑ Rock El CMU ❑ Concrete ® Other: lock n load *Total new impervious area including all buildings, sidewalks, and .avin,: s.. ft. talif,higig.1,01111Mit AMU Site Utilities Plumbing Work: Complete the Plumbing Permit Application for site utilities plumbing work. Plans Required: See"Site Work Permit Application-Plan Submittal Requirements"attached. The following must accompany this application: ® Site Plan with Vicinity Map showing ADA ❑ *Parking(including ADA)and Lighting compliance Plan ® Grading Plan and details ® *Landscaping Plan ® Erosion Control Plan and details ❑ Soils Report(if required) Retaining Structures *Does not apply to One-and Two-family dwellings. Plan Submittal: Permit Fee: , L 1l MITTAL 1,00 of "V ;l fJ s 400, � 1 s or R.e+ �e t $.00 to$500.00 $51.09 minimum permit fee 'sukiiIt(****F $500.01 to$2,000.00 $51.09 for the first$500.00 and 014r5 $2.69 for each additional$100 or fraction Commercial 3 thereof,to and including$2,000.00. $2,000.01 to$25,000.00 $91.44 for the first$2,000.00 and Multi-Family R-1 Occupancy 3 $10.76 for each additional$1,000 or fraction thereof,to and including $25,000.00. One-&Two-Family Dwelling 3 $25,000.01 to$50,000.00 $338.92 for the first$25,000.00 and $8.06 for each additional$1,000.00 or fraction thereof,to and including $50,000.00. $50,001.00 to$100,000.00 $540.42 for the first$50,000.00 and $5.38 for each additional$1,000.00 or fraction thereof,to and including $100,000.00. $100,000.01 and over $809.42 for the first$100,000.00 and $4.49 for each additional$1,000.00 or fraction thereof. I:\Building\Permits\SIT-PermitApp.doc 08/02/2016 2 1,1 • Site Work Permit Application Plan Submittal Requirements TI( A R[T) Commercial, Multi-Family and One- &Two-Family Dwellings A site work permit is required for all commercial projects including new buildings, additions, accessory buildings larger than 120 square feet, modular structures and multi-family R-1 occupancies. A site work permit is required for excavation, fill,grading,paving, retaining walls, fire hydrants and fire department access on private property for work on individual lots not covered under the subdivision development. Note: A separate "plumbing" permit for site utility plumbing work is required for sanitary sewer, storm sewer and potable water systems on private property. Please see the Site Utilities - Plumbing Permit Application for plan submittal requirements. 1. SITE PLAN and vicinity map (fully dimensional, drawn to scale) showing the geographic location labeled with: A. ® map &tax lot# ® project name ® site address ® suite number ® zoning ® applicant name ® applicant phone number B. North arrow. C. Scale (architectural or engineering only). D. Street names. E. Building pads (drawn to scale)with project location. 2. BUILDING PLAN submittal requirement: Three (3) complete sets, Civil only. All details listed below shall be incorporated into the plans: A. Site plan showing: 1) Required parking spaces and driveways. 2) A route,accessible to persons with disability,leading from the public way to an accessible building entrance. 3) Accessible parking spaces and adjacent access aisle connecting with the accessible route. 4) Curb ramps along the accessible route, curb, sidewalk and gutter. 5) Finish grade elevations along the accessible route. B. Topographic survey plan showing grade elevations crossing the entire site. C. Overall grading plan. D. Utilities plan showing: 1) Fire hydrant location and pipe size if on private property. 2) If the building is to be protected with an automatic fire sprinkler system, show location of the water service vault and the fire department connection (FDC) within 70 feet of a fire hydrant. 3) Size of underground water service for the sprinkler system. E. Erosion control plan complying with the requirements of the Clean Water Services (CWS) agency showing: 1) Silt fence locations. 2) Bio-filter bags/other approved barrier material surrounding catch basins. I:\Building\Permits\SIT-PermitApp.doc 08/02/2016 3 3) Illustrations detailing the correct installation of the silt fencing and catch basin protection. 4) Any other measures to ensure compliance with CWS standards. F. Landscaping plan. 3. ADDITIONAL REQUIREMENTS: A. Soils (geotechnical) report. A soils report is required for new buildings and additions to contain the following: 1) The report shall address the potential of soil liquefaction and instability (OSSC Sec. 1804.2). 2) Fills to be used to support foundation of buildings (OSSC Sec. 3301.1). 3) Foundation and lateral pressures exceeding 1,500 lb./sq. ft. (OSSC Sec. 1805). B. Fire flow and hydrant worksheet. C. Plan review deposit based upon project valuation. I:\Building\Permits\SIT-PermitApp.doc 08/02/2016 4 My 1? 14 .r319 Pacific Community Design Transmittal DATE: March 14, 2019 TO: City of Tigard, Building Department RE: Roshak Ridge Swim Center Site Work Permit Application PROJECT NO: 395-010 Via: ® Messenger: ❑ Mail ❑ Overnight ❑ Pick-up ❑ Electronic Rush / Route ❑ Fax pages (including this page) Fax No. 000-000-0000 Transmitted: ❑ FOR APPROVAL ❑ FOR REVIEW AND COMMENT ❑ FOR YOUR USE ® AS REQUESTED 111 Attached: COPIES DATE DESCRIPTION 1 3/13/19 Signed Roshak Ridge Site Work Permit Application 3 3/08/19 Full-size Plan sets 1 11/27/18 Structural Calculations REMARKS: j' SIGNED: MI Eric Hawki . Mail: 12564 SW Main Street, Tigard, OR 97223 Phone: (503) 941-9484 Website: www.pacific-community.com Fax: (503) 941-9485 City of Tigard 1111 COMMUNITY DEVELOPMENT DEPARTMENT T1cnRD Building Permit Review — Commercial - With Land Use Building Permit #: l — (�7g7} Site Address: { 14 50 c w R vt f I .t-rzLL, B(vC( Suite/Bldg#: Project Name: (Lc S' VL. 4 i c(Cie S W, M CC() >' (Name of commercial business occupying the space. If vacant,enter Spec Space.) Planning Review Proposal: \ W C r k Co( S W'i VY") Verify site address/suite# exists and active in permit system. /River Terrace Neighborhood: /.Yes ❑ No Land Use Case#: P D 1- ZC l 5 - o ocC'I Plans Match Approved Land Use: XSite Plan ❑ Landscape Plan ❑ Other: ❑ Urban Forestry Plan ❑ Elevation Plan Building Height: C4(. Vv u r kMaximum Height -- 1-44eiglit - 1\r`/A pConditions Met: ❑ Prior to Submittal Prior to Permit Issuance /Z. Business License: Exists: ❑ Yes ❑ No,applicant notified to obtain business license pr Public Facilities Improvement (PFI) Permit: 'c]'2b 1--, _ 0© j `Z Required: ❑ Yes,applicant was notified ❑ No Applied For: X Yes ❑ No, stop intake Notes: Approved by Planning: Kt, Date: - IIA , i Revisions (after Building Submittal only) Reviewer Date Revision 1: ❑ Approved ❑ Not Approved Revision 2: ❑ Approved ❑ Not Approved Revision 3: ❑ Approved ❑ Not Approved Building Permit Submittal Original Submittal Date: 3/q G Site Plans: # Building Plans: # Building Permit#: ► nter building ermit#above. Workflow Routing: �'Planning ngineering Permit Coordinator _Building Workflow Sign-off: S Sign-off for P1 nning(include notes from planning review) / Route Application Documents: �' Building: original permit application,site plans,building plans,engineer and beam calculations and trust details,if applicable, etc. Notes: AI By Permit Technician: 411011,e � Date: g 7//2-/T I:\Building\Forms\BldgPerndtRvw_COM_WithLandUse_060116.docx Engineering Review 5-0 79 ,❑' Slope at building pad: ❑ PFI Permit#: ,0-'Conditions "Met"prior to issuance of building permit ❑ Easements (encroachments) per engineering conditions of approval and plat(not typical on SDR/CUP) ,Water Quality/Quantity Facility: Assess Water Quality Fee in-lieu: E Yes Er No Assess Water Quantity Fee in-lieu: ❑ Yes 2. No LIDA Facility on lot: ❑ Yes ,B'No ❑ NOT Approved by Engineering: Date Notes: Approved by Engineering: 14 Date: 3 a i 7 Revisions (after Building Submittal only) Reviewer Date Revision 1: 0 Approved 0 Not Approved Revision 2: 0 Approved 0 Not Approved Revision 3: 0 Approved 0 Not Approved Permit Coordinator Review ❑ Conditions "Met"prior to issuance of building permit ❑ Approved,NOT Released: Date: Notes: Revisions (after Building Submittal only) Revision Notice 1: Date Sent to Applicant: Revision Notice 2: Date Sent to Applicant: R *sion Notice 3: Date Sent to Applicant: �/ DC Fees Entered: Wash Co Trans Dev Tax: 0 Yes I N/A Tigard Trans SDC: 0 Yes __ A ./ Parks SDC: ❑ Yes N/A ❑ OK to Issue Permit Approved by Permit Coordinator: 4141-Date: 'u1 v `)4 I:\Building\Forms\BldgPennitRvw COM_WithLandUse 070915.docx